An eventful time for perinatal mental health

The perinatal mental health (PMH) team at NHS England is just one of many teams and individuals passionate about improving PMH care. In this blog, Dr Jo Black, one of NHS England’s Associate National Clinical Directors for Perinatal Mental Health, provides an update on the progress being made to expand specialist community perinatal mental health services and the challenges that lie ahead in the next year.

Some express it loudly and proudly, like the conference speakers and the brilliant PMH community on social media. Some quietly, through unsung everyday acts among peer supporters, fund raisers, volunteers and family members. Others working in politics, the third sector, health and social care do their jobs and much more to push for the needs of mums, babies and families in their areas. We are united in pulling in the same direction, and I am eternally grateful.

Twenty areas across England have recently celebrated successful applications in the first wave of funding for development and expansion of specialist community PMH services. There was a huge amount of interest in this wave, meaning that if your team wasn’t successful, please don’t lose heart.  The fund size was limited and many proposals were very close to the line, but didn’t quite make it. Wave 2 is coming and it’s important to build on what you’ve already done to help your chances of success in this next funding round.

NHS England’s PMH team has now sent feedback on all unsuccessful applications from Wave 1. Take some time to read this, alongside your application, to reflect on where it aligns or diverges from the guidance document. We will also be asking successful applicants from Wave 1 to share their learning widely now, and in the future, as support for those planning to apply for Wave 2. I would encourage you to use this period to build relationships across your patch to ensure that the majority of funding, which will be in baselines from 2019/20, is spent to achieve the best possible outcomes.

Whether you are in the early waves or not, it is time to put in place the PMH team you need to deliver your core work. Some proposals were unsuccessful because the core work was hard to see. If your proposal represents a broad range of stakeholders, perhaps getting back to basics and agreeing amongst you, a shared understanding of the core work of the service is something you could begin to do now.  Please do prioritise this – your proposal will be much stronger for it.

I’d like to congratulate all of those who were successful in Wave 1. We know that these proposals were pulled together across regions and organisations at pace – and delivering these plans will not be straightforward. Many of you will need to collaborate across clinical commissioning groups (CCGs), provider trusts and significant geographical patches. I urge you to continue to put the needs and experience of women and families right at the centre of your planning.

Think about those at the furthest reaches of your area: mothers and babies with other health (physical and mental) issues, young parents, those with mental health problems and learning difficulties, the mothers and communities from diverse backgrounds who live and have babies in your patch. The more you listen to and plan with parents, the stronger your emerging team will be. Finally, wherever you can, please keep sharing your learning through the clinical networks – both what works and what doesn’t work. We should see ourselves as a team with a single, united goal and anything we can do to help others in the team will help us all.

I am aware some areas may not have submitted bids for Wave 1 because some CCGs are nervous that this may not be ‘real money’, that it may dry up and trusts and CCGs will be left picking up costs. I recognise the huge pressure CCGs and Sustainability and Transformation Plans (STPs) are under and I urge commissioners to connect with their regional PMH clinical network and with commissioning peers from other patches.

I’d also encourage them to revisit the NHS England specialist PMH commitment in theFive Year Forward View and the associated Implementation Plan which highlights that this new money will be mainstreamed into CCG allocations from 2019/20 to further support the development of specialist perinatal mental health teams and to improve quality. Together we are turning the Maternal Mental Health Alliance  map green –make sure you are not left out of an ever improving national picture.

With so much going on, PMH needs leaders at all levels and in many areas – so if you want to develop a career in perinatal mental health, now is a great time for you! If you have expertise then please be brave and apply for new challenging leadership roles.

Over the next five years perinatal mental health services will be unrecognisable. I am thankful for all the work which has gone on and still goes on and those involved have a lot to be proud of.

Dr Jo Black

Dr Jo Black is a consultant perinatal psychiatrist with Devon Partnership NHS Trust, SW regional representative on the perinatal faculty at the Royal College of Psychiatrists and Chair of the Regional Reps Committee. She has developed an integrated community perinatal mental health service, with perinatal expertise embedded in the three maternity units serving families in Devon.

Jo has experience of working with teams, bringing together clinical, management and commissioning colleagues from primary care, acute and mental health services, women, families and colleagues from the third sector. She looks forward to bringing her energy, experience and ideas to this national role.